Two Cases of Fatal Inhalation of Easily Available "Recreational" Substances

ABSTRACT

We present 2 cases of fatal inhalation of easily available highly volatile substances that occurred in a recreational context. Case 1 concerns an 18-year-old man who was found dead with a 25-L plastic bag pulled over his head and a whipped cream steel siphon connected to the bag. The deceased was known to previously have inhaled nitrous oxide. Autopsy results were unremarkable, toxicological analysis using static headspace gas chromatography coupled to mass spectrometry analysis proved the presence of nitrous oxide in lung tissue and blood. Asphyxiation was ascertained as the cause of death. Case 2 describes the death of a 54-year-old man found dead on his bed wearing a rubber gas mask. A bottle with ethyl chloride-containing cold spray was found beside him. Autopsy did not reveal relevant pathological findings; a subsequent toxicological analysis proved the presence of ethyl chloride. Respiratory arrest because of ethyl chloride inhalation was established as the cause of death. The 2 cases presented here demonstrate the danger of easily available, volatile substances with a high potential for abuse. A careful investigation of the death scene, proper specimen collection during the autopsy, and extensive toxicological tests, including headspace gas chromatography coupled to mass spectrometry analysis, are necessary to prove inhalation of these substances.

Chemical Processing of Wool: Sustainability Considerations

Raw wool fibers contain fat, suint, plant material and minerals. It is necessary to remove these from wool by scouring with a combination of detergents, wetting agents and emulsifiers before further processing. Dyeing and finishing of wool fibers is necessary for their application in apparel and also in interior, automotive, smart and technical textiles. Some of the detergents and auxiliaries used in scouring are eco-toxic and some of them are endocrine disruptors. In many countries, wool scouring and dyeing effluents cannot be discharged to watercourses without further treatment by removing color and toxic components. Wool fibers can be given chemical treatments to make them stain-resistant, flame retardant, shrink-resistant, photo-stable and resistant to insect attack. Some of the chemicals under current practice to achieve these functionalities in wool are not eco-friendly and their discharge to water course is limited to the consent limit set by environment agencies. Environmental impact assessment of raw wool production is well studied but to our knowledge no comprehensive study has been carried out around the environmental impact of chemical processing of wool. Like those of other fiber types, the wool textile industries are under intense consumer as well as stakeholder scrutiny. Accreditation schemes now exist to provide reassurance to modern consumers, who want to see that not only are the marketed products safe but also that they are processed sustainably under ethically and environmentally acceptable conditions. Several alternatives to improve the environmental credentials of various chemical processes used for wool will be discussed.

Headspace-free setup of in vitro bioassays for the evaluation of volatile disinfection by-products

The conventional setup of in vitro bioassays in microplates does not prevent the loss of volatile compounds, which hampers the toxicological characterization of waterborne volatile disinfection by-products (DBPs). To minimize the loss of volatile test chemicals, we adapted four in vitro bioassays to a headspace-free setup using eight volatile organic compounds (four trihalomethanes, 1,1-dichloroethene, bromoethane, and two haloacetonitriles) that cover a wide range of air-water partition coefficients. The nominal effect concentrations of the test chemicals decreased by up to three orders of magnitude when the conventional setup was changed to a headspace-free setup for the bacterial cytotoxicity assay using bioluminescence inhibition of Vibrio fischeri. The increase of apparent sensitivity correlated significantly with the air-water partition coefficient. Purge and trap GC/MS analysis revealed a reduced loss of dosed volatile compounds in the headspace free setup (78-130% of nominal concentration) compared to a substantial loss in the conventional set up (2-13% of the nominal concentration). The experimental effect concentrations converged with the headspace-free setup to the effect concentrations predicted by a QSAR model, confirming the suitability of the headspace-free approach to minimize the loss of volatile test chemicals. The analogue headspace-free design of the bacterial bioassays for genotoxicity (umuC assay) and mutagenicity (Ames fluctuation assay) increased the number of compounds detected as genotoxic or mutagenic from one to four and zero to two, respectively. In a bioassay with a mammalian cell line applied for detecting the induction of the Nrf-2-mediated oxidative stress response (AREc32 assay), the headspace-free setup improved the apparent sensitivity by less than one order of magnitude, presumably due to the retaining effect of the serum components in the medium, which is also reflected in the reduced aqueous concentrations of compounds. This study highlights the importance of adapting bioanalytical test setups when volatile/semivolatile compounds are present in the sample to avoid the loss of chemicals and thus to avoid underestimating the toxicity of mixtures and complex environmental samples.

Physical and physicochemical factors effecting transport of chlorohydrocarbon gases from lung alveolar air to blood as measured by the causation of narcosis

This systematic investigation examines gas transport in the lung for two sets of chlorohydrocarbons (CHCs): the chloromethanes (C1) and chloroethanes (C2). The C1 series includes chloromethane, methylene chloride, chloroform, and carbon tetrachloride, and the C2 series includes chloroethane, 1,2-dichloroethane, 1, 1, 2-trichloroethane, and 1, 1, 2, 2-tetrachloroethane. Most CHC gases cause narcosis. The comprehensive narcosis work of Lehmann and colleagues on CHCs was used as a basis for the narcosis endpoint in the present examination. The sites for narcosis are located in the brain (midline cortex and posterior parietal area), the spine, and at many peripheral nerve sites. Central nervous system (CNS) exposure executes a multisite, neural transmission set of inhibitions that promotes rapid loss of consciousness, sensory feeling, and current and stored memory while providing temporary amnesia. Absorption into the system requires dissolution into many lipid membranes and binding to lipoproteins. Lipophilicity is a CHC property shared with many anesthetics according to the Meyer-Overton Rule. Many structurally different lipid chemicals produce the narcosis response when the lipid concentration exceeds -67 mM. This suggests narcotic or anesthetic dissolution into CNS membranes until the lipid organization is disrupted or perturbed. This perturbation includes loading of Na(+)- and K(+)-channel transmembrane lipoprotein complexes and disrupting their respective channel functional organizations. The channel functions become attenuated or abrogated until the CHC exposure ceases and CHC loading reverses. This investigation demonstrates how the CHC physical and chemical properties influence the absorption of these CHCs via the lung and the alveolar system on route to the blood. Narcosis in test animals was used here as an objective biological endpoint to study the effects of the physical factors Bp, Vp, Kd (oil: gas) partition, Henry's constant (HK), and water solubility (S%) on gas transport. Narcosis is immediate after gas exposure and requires no chemical activation only absorption into the blood and circulation to CNS narcotic sites. The three physical factors Bp, K(d) (oil: air), and S% vary directly with unitary narcosis (UN) whereas Vp and HK vary inversely with UN in linear log-log relationships for the C2 series but not for the C1 series. Physicochemical properties of C1 series gases indicate why they depart from what is usually assumed to be an Ideal Gas. An essential discriminating process in the distal lung is the limiting alveolar film layer (AFL) and the membrane layer of the alveolar acini. The AFL step influences gas uptake by physically limiting the absorption process. Interaction with and dissolution into aqueous solvent of the AFL is required for transport and narcotic activity. Narcotics or anesthetics must engage the aqueous AFL with sufficient strength to allow transport and absorption for downstream CNS binding. CHCs that do not engage well with the AFL are not narcotic. Lipophilicity and amphipathicity are also essential solvency properties driving narcotics' transport through the alveolar layer, delivery to the blood fats and lipoproteins, and into critical CNS lipids, lipoproteins, and receptor sites that actuate narcosis. AFL disruption is thought to be strongly related to a number of serious pulmonary diseases such acute respiratory distress syndrome, infant respiratory distress syndrome, emphysema, chronic obstructive pulmonary disease, asthma, chronic bronchitis, pneumonia, pulmonary infections, and idiopathic pulmonary fibrosis. The physical factors (Bp, Vp, Kd [oil: gas] partition, Henry's constant, and water solubility [S%]) combine to affect a specific transport through the AFL if lung C > C(0) (threshold concentration for narcosis). The degree of blood CHC absorption depends on dose, lipophilicity, and lung residence time. AFL passage can be manipulated by physical factors of increased pressure (kPa) or increased gas exposure (moles). Molecular lipophilicity facilitates narcosis but lipophilicity alone does not explain narcosis. Vapor pressure is also required for narcosis. Narcotic activity apparently requires stereospecific processing in the AFL and/or down-stream inhibition at stereospecific lipoproteins at CNS inhibitory sites. It is proposed that CHCs likely cannot proceed through the AFL without perturbation or disruption of the integrity of the AFL at the alveoli. CHC physicochemical properties are not expected to allow their transport through the AFL as physiological CO(2) and O(2) naturally do in respiration. This work considers CHC inspiration and systemic absorption into the blood with special emphasis on the CHC potential perturbation effects on the lipid, protein liquid layer supra to the alveolar membrane (AFL). A heuristic gas transport model for the CHCs is presented as guidance for this examination. The gas transport model can be used to study absorption for other gas delivery endpoints of environmental concern such as carcinogens.